NPI | 1932345899 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: NC 3179) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA psy5666) |
Enumeration Date | 2008-12-25 |
Last Update Date | 2009-04-19 |